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DHHS Report (NACNEP): The Role of Nurses in Primary Care (2010) May 27, 2017

Posted by mariemanthey in Professional Practice.
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The Role of Nurses In Primary Care (DHHS, 2010)


Continuing the celebration of Nurse’s Month, here’s a great document from the US Govt supporting the importance of nursing and the connection between Nursing and Quality Patient Care.  The full link is at the top of this post. The Executive Summary is included here in full.

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Executive Summary
As the projected demand for primary care increases exponentially and provider shortages intensify, necessity is driving a re-examination of the roles of nurses in primary care. The National Advisory Council on Nurse Education and Practice (NACNEP) convened two meetings in 2009-2010 to examine
the roles of nurses in primary care and strategies to increase workforce capacity and effectiveness, reduce barriers to practice, and strengthen the education of nurses for primary care.

Nurses have key responsibilities for the essential components of primary care articulated by the Institute of Medicine (IOM): integrating care, increasing accessibility to care, addressing a large majority of personal health care needs, building sustained partnerships with patients, and practicing in the context of family and community (Institute of Medicine [IOM], 1996). Their close proximity to patients in every setting where primary care is delivered provides unique opportunities for nurses to influence health outcomes and cost effectiveness.

The NACNEP identified three overarching recommendations to increase access to quality primary care in the United States:

(1) Decrease barriers to primary care nursing in the United States.

The Congress and the Secretary of the U.S. Department of Health and Human Services should leverage resources to enhance primary care capacity by promoting the removal of regulatory barriers that prohibit primary care nurses from fully exercising their scope of practice. The Secretary and Congress should compel federal and state governmental bodies to revise Medicare and Medicaid funding stipulations that inhibit access to primary care directly through regulatory scope of practice challenges or indirectly through inequitable reimbursement challenges. Additionally, the Congress and the Secretary should ensure reimbursement policies are provider neutral and adequate to sustain primary care practice including nurse-led models such as nurse- managed health centers.

(2) Promote educational initiatives that support and strengthen the nursing primary care workforce.
The Secretary and Congress should leverage federal, state and local governmental financial resources to build primary health care educational program capacity and increase clinical training sites that support interprofessional team competencies and innovative technology. The Secretary and Congress should support the development, implementation, and evaluation of primary care residencies/fellowships for nurses in teaching health centers and other community-based settings to increase the nursing workforce capacity to meet increased consumer demand for primary care.

(3) Support successful nurse models of primary care.

The Secretary and Congress should leverage federal, state, local government and private resources to expand current successful models of primary care services such as nurse-managed clinics, nurse/family partnerships, and school-based nursing clinics; and evaluate outcomes using comparative effectiveness. The Secretary and Congress should support the development and testing of innovative models to meet the primary care needs of specific populations such as nursing home residents, individuals with behavioral health issues and children with special needs. Additionally, Congress should support the development and testing of innovative nurse-led models in the medical home demonstration to expand the capacity of primary care and meet the changing public health needs for primary care. Lastly, the Secretary and Congress should increase access to and consumer engagement in primary care through convenient locations and creative use of consumer-oriented technology.

This report to the Secretary of the U.S. Department of Health and Human Services and the Congress summarizes the proceedings of the NACNEP meetings of November, 2009 and April, 2010.



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